MANUAL MINORS
A neck sprain, also known as a cervical sprain, occurs when the ligaments in the neck, which connect the cervical vertebrae, are stretched or torn due to trauma or sudden movement. It is a common injury in car accidents (whiplash), falls, or sports activities involving violent flexion and extension movements. Cervical sprains cause pain, stiffness, and sometimes limitation of neck movement.
Diagnosis
Diagnosis is based on the history of trauma or sudden movement, followed by neck pain and stiffness, which may appear immediately or within 24-48 hours after the event. Physical examination reveals tenderness in the back of the neck and limited range of motion.
In mild cases, imaging studies are not required, but in severe trauma or suspected fractures or neurological damage, X-rays or magnetic resonance imaging (MRI) should be performed to rule out more serious injuries.
Differential Diagnosis
Pathology | Characteristics |
|---|---|
Cervical disc herniation | Pain radiating to the arms, associated with weakness or tingling |
Cervical fracture | Severe pain following major trauma, with marked movement restriction |
Myositis | Muscle pain without traumatic history, often related to infections or inflammation |
Whiplash | Similar to a sprain, associated with car accidents and rapid neck movements |
Acute torticollis | Severe muscle spasm with movement limitation and antalgic posture |
Emergency Management
In the emergency setting, management of a cervical sprain includes immobilising the neck with a soft collar to reduce movement and allow ligament healing. Pain relief is achieved with analgesics and non-steroidal anti-inflammatory drugs (NSAIDs), along with muscle relaxants if there is muscle spasm.
In the first few days following the trauma, ice application can help reduce inflammation. If fracture or neurological damage is suspected, imaging studies must be performed before any further manipulation.
Definitive Treatment
Definitive treatment is conservative in most cases. This includes using a soft cervical collar for a short period (no more than 1-2 weeks to avoid stiffness), followed by physiotherapy to strengthen the neck muscles and improve range of motion. Stretching exercises and muscle relaxation techniques help prevent future injuries.
For chronic cases or persistent pain, treatments such as physical therapy and local heat application may be considered to relieve muscle pain. Full recovery typically occurs in 4 to 6 weeks, depending on the severity of the sprain.
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